MEDICARE: STEPHANIE ANILO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	37PC00431600	NJ

General Provider Information

NPI Number	:	1639543549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ANILO

Provider Business Mailing Address
First Line	:	1613 BEAVER DAM ROAD SUITE 100
Second Line	:
City	:	POINT PLEASANT
State	:	NJ
Zip	:	08742
Country	:	US
Telephone Number	:	848-448-1680
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 BEAVER DAM RD STE 100
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-5171
Country	:	US
Telephone Number	:	848-448-1680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2015
Last Update Date	:	11/17/2015

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Directions to “ STEPHANIE ANILO ” Practice Location

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